This document summarizes information about Medicare coverage options. It discusses who is eligible for Medicare and what Parts A and B cover. It also describes supplemental plans like Medigap and Medicare Advantage plans, noting their benefits and costs. Examples are provided to illustrate out-of-pocket expenses under different coverage options. The summary concludes that having original Medicare with a Medigap plan and Part D prescription drug coverage provides the most comprehensive coverage at the lowest cost, but a Medicare Advantage plan may also be suitable depending on individual needs and circumstances.

2. Medicare Seminar

3. Medicare Seminar Overview What is Medicare? Who is eligible? What benefits does Medicare cover? What benefits doesn’t Medicare cover? What other coverage is available? Medicare enrollment periods. Things to consider when choosing coverage.

13. Medicare Supplement Plans Note* Plans F & J offer high-deductible versions . Note** Plans K&L include a yearly out-of-pocket limit. Plan K limit is $4,620.00 Plan L limit is $2,310.00 After you pay out-of-pocket limit plus your yearly Part B deductible the plans pay %100 of covered services for the calendar year.

15. Medicare Supplement Plans: Food for Thought “ Every Medigap policy must follow Federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Medigap insurance companies can only sell you a “standardized” Medigap policy identified by the letters A through L. Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it. Cost is usually the only difference between Medigap policies sold by different insurance companies.” From page 9 of Choosing a Medigap Policy: A Guide to Health Insurance of People with Medicare distributed by the Centers for Medicare & Medicaid Services .

22. Medicare Prescription Drug Coverage The bottom line is to get a Part D plan if you are on original Medicare Parts A and B whether or not you have little or no prescription drug costs. The reason is that like all insurance, you acquire it to manage risk. And if you don't sign up in your initial eligibility period, the premium will increase 1 percent for each month until you do enroll.

23. Medicare Advantage Plans The Medicare program pays health insurance companies to provide health care coverage that replaces Part A and B. These plans are called Medicare Advantage Plans. Their coverage may include benefits not provided by original Medicare. With an Advantage plan, you pay the Part B premium, plus any insurance premium. But you are no longer covered by original Medicare Parts A and B.

30. Example 1: Out-of-pocket Expenses for Hospital Stay of 3 Days and Skilled Nursing Facility Stay of 30 Days for Rehab. The Example does not include doctor or surgical expenses. Original Medicare would require 20% Coinsurance. Advantage plan would require prior approval by insurance company for any procedure. Popular Medigap plan along with Medicare Parts A & B would cover 100% of all Medicare approved procedures.

31. Example 2: The Example does not include doctor or surgical expenses. Original Medicare would require 20% Coinsurance. Advantage plan would require prior approval by insurance company for any procedure. Popular Medigap plan along with Medicare Parts A & B would cover 100% of all Medicare approved procedures. Out-of-pocket Expenses for Hospital Stay of 10 Days and Skilled Nursing Facility Stay of 60 Days for Rehab.

32. Example 3: Out-of-pocket Expenses for Hospital Stay of 90 Days and Skilled Nursing Facility Stay of 100 Days for Rehab. The Example does not include doctor or surgical expenses. Original Medicare would require 20% Coinsurance. Advantage plan would require prior approval by insurance company for any procedure. Popular Medigap plan along with Medicare Parts A & B would cover 100% of all Medicare approved procedures.

33. Some Conclusions A: Have original Medicare Parts A and B and with a Medigap policy and a Part D plan. This combination provides the most complete basic coverage with the least potential for out-of-pocket expenses. OR B: Have a Medicare Advantage plan that includes Part D drug coverage. The premiums if any will be less than the combined premiums of a Medigap and Part D policy. There will be additional benefits for preventive care including annual physicals exams. However, you will be responsible for deductibles and copays.

34. Some Conclusions C: We cannot recommend what type of Medicare health strategy is best for everyone. Each beneficiary has a different set of circumstances. What is most important is that each individual should understand what types of insurance plans are available, whether it be Medigap, Medicare Advantage, or stand-alone Part D prescription drug plan. We do recommend that you seek help from a health care advocate including family members and friends to determine what strategy is best for you.

35. Questions and Answers

36. For additional information you may contact: Medicare: 1-800-MEDICARE (TTY: 1-877-486-2048) or www.medicare.gov Social Security: 1-800-772-1213 (TTY: 1-800-325-0778) or www.ssa.gov